SOLDIER'S DATA SHEET

SOLDIER'S PERSONAL DATA SHEET

DATE

PRIVACY ACT OF 1974 COMPLIANCE INFORMATION The following information is provided in accordance with 5 U.S.C. 552a(e)(3) and applies to this form. Authority for collection of the information is 44 U.S.C. 2907, 3101, and 3103, and E.O. 9397 of November 22, 1943. Disclosure of the information is voluntary. The purpose of the information on this form is to assist your unit servicing the records. This form is then filed in the requested military service record as a record of disclosure. The form may also be disclosed to Department of Defense components, the Department of Veterans Affairs, the Department of Transportation (Coast Guard), or the National Archives and Records Administration when the original custodian of the military health and personnel records transfers all or part of those records to that agency. If the service member was a member of the National Guard, the form may also be disclosed to the Adjutant General of the appropriate state,District of Columbia, or Puerto Rico, where he or she served. The following information will not be shared with any unauthorized personal.

NAME

SSN

RANK/GRADE

ORGANIZATION

PMOS

SMOS

DATE OF BIRTH

AGE

WEIGHT lbs HEIGHT in inches HAIR

EYES

BLOOD TYPE

DATE OF RANK

BASD

ETS

TIG

TIS

RELIGION

22. ADDRESS

HOME PHONE

PROMOTABLE

POINTS

DATE LAST NCOER

YES

NO

DEPENDENTS

MARITAL STATUS

MARRIED

SINGLE

DIVORCED

SEPARATED

SPOUSE'S NAME

EFMP

DATE OF MARRIAGE

YES

NO

CHILD'S NAME

EFMP

AGE

SEX

YES

NO

CHILD'S NAME

EFMP

AGE

SEX

YES

NO

CHILD'S NAME

EFMP

AGE

SEX

YES

NO

CHILD'S NAME

EFMP

AGE

SEX

YES

NO

IF YOU HAVE MORE THEN FOUR CHILDREN OR HAVE ANY SPECIAL NEEDS FOR YOUR FAMILY DICTATE IT IN REMARKS.

NEXT OF KIN

NAME

ADDRESS

ALTERNATE NAME

PHONE 8 NOV 2006

ALTERNATE PHONE

ALTERNATE ADDRESS

PAGE 1of 2

DATE LAST APFT

PUSH-UPS

ARMY TRANING

SIT-UPS

RUN TIME

TOTAL SCORE

DATE LAST WEIGH-IN

BODY FAT%

TYPE OF PROFILE (EXPLAIN)

ALLOWABLE FAT% PROFILE

TEMPORARY

PERMANENT

DATE WEAPON QUAL

WEAPON TYPE QUALIFIED

MARKS MEN

SHARP SHOOTER

EXPERT

DATE CREW SERVED WEAPON QUAL TYPE

QUALIFIED

MARKS MEN

SHARP SHOOTER

EXPERT

DATE CTT TEST

DATE DRIVERS TRAINING TYPE OF VEHICLE

GO

NO GO

DATE PLDC

DATE BNCOC

DATE ANCOC

NBC SUIT SIZE

ARMY EQUIPMENT NBC MASK SIZE NBC BOOT SIZE NBC GLOVE SIZE HAT SIZE

ACU TOP SIZE

ACU TROUSER SIZE

BOOT SIZE

ARMY AWARDS DECORATIONS AND ACHIEVEMENTS

TYPE

#

TYPE

#

TYPE

#

TYPE

#

MAKE

MODEL

PRIVATELY OWNED VEHICLE

YEAR

COLOR

LIC PLATE POST DEC INS CO,

EXP DATE

REMARKS 8 NOV 2006

PAGE 2 of 2

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